Immunohistochemical Expression Of Estrogen Receptors Research Articles

Subtyping of Breast Carcinoma According to ER/PR and HER2/neu Expression: A Cross-Sectional Study from Southern Part of Assam, India

Introduction: Globally, breast carcinoma is the most prevalent and lethal form of cancer in women. Breast cancer is no longer considered a single disease but a complex heterogeneous disease with multiple genetic and epigenetic alterations. The prognosis and management of the disease depend on histological stage, type, grade, tumour size, lymph node status, and the status of hormonal receptors like ER, PR, and Her2/ neu. Recently, more attention has been given to the molecular classification of breast cancer. Aim: To analyse and compare the clinicopathological characteristics of invasive breast cancer in the four breast carcinoma subtypes defined by the immunohistochemical expression of Estrogen Receptor (ER), Progesterone Receptor (PR), and Human Epidermal Growth Factor Receptor 2 (Her2/neu). Materials and Methods: The cross-sectional study was conducted on 64 primary invasive breast carcinoma cases diagnosed on mastectomy specimens between February 1, 2018, and July 30, 2022, in the Department of Pathology at the histopathology section of Silchar Medical College and Hospital, Silchar, Assam, India. Age and tumour characteristics (morphology, grade, stage, and size) and nodal disease status were included in the data for analysis. Immunohistochemical markers were analysed on the sections of these diagnosed cases. IBM Statistical Packages for Social Sciences (SPSS) software was used for data analysis. Qualitative data was presented as frequency and percentage, while quantitative data was presented as mean ±{Standard Deviation (SD)}. The Chi- square test was used to determine the statistical significance of hormonal receptors with the various clinicopathological features. A p-value of <0.05 was considered statistically significant. Results: In present study of 64 cases of invasive breast carcinoma, the mean age of patients was 51.95±12.72 years. Subtyping was performed based on hormonal receptors. Authors found that the Luminal A variety 33 (51.6%) was the most common hormonal subtype in present study, followed by the basal subtype 24 (37.5%). The Luminal A subtype was found to be predominant among others. The majority of the patients (59.4%) had stage-I tumours, and Ductal type carcinoma was the most common (57.8%). Histologically, most of the tumours were poorly differentiated (28, 43.8%), and most were sized ≤2 cm (41, 64.1%). Lymph nodes were not palpable in most of the patients (43, 67.2%). Subtype comparison with respect to age, stage, histological grade, type, size, and nodal status revealed statistically significant outcomes (p-value of <0.05). Conclusion: Classification based on Immunohistochemistry (IHC) provides prognostic and therapeutic information that cannot be obtained from either ER/PR or Her2/Neu status alone. The present study provides the incidence of different molecular subtypes in the southern region of Assam, and comparison among them with statistical correlation offers improved and crucial treatment guidance. IHC classification as a clinical tool for ER/PR and Her2/Neu testing is widely accessible, reasonably priced, based on immunophenotype/biologic phenotype categorisation of breast cancer, and is prognostic as well as partly predictive and needs to be practiced invariably.

Immunohistochemical Expression of Estrogen Receptors in Pleomorphic Adenoma and Normal Salivary Gland Tissue

Background: The expression of estrogen receptors (ERs) in salivary gland tissue has been observed in some studies. Considering the histological similarity of salivary glands and breast tissue, as well as the prominent role of this receptor in the pathogenesis, treatment, and prognosis of breast tumors, this study aimed to compare the immunohistochemical expression of ERs in pleomorphic adenoma (PA) and normal salivary gland tissue and assess its possible role in salivary gland tumors. Methods: In this descriptive-analytical study, 26 samples of PA (16 females, and 10 males) and 12 samples of normal salivary gland tissue were selected. Immunohistochemical staining was performed by the standard EnVision method for ERs. The results were evaluated semi-quantitively as the percentage of the nuclear and cytoplasmic staining were analyzed independently by Mann-Whitney, Kruskal-Wallis, and Fisher’s exact tests. Results: All PA samples showed negative nuclear staining for ERs. ER expression was observed in the cytoplasm of the ducts in 27% of tumors and 59% of normal salivary gland tissue samples, but the difference was not statistically significant. In addition, no association was found between ER expression and independent variables, such as age, sex, the type of stroma, or the degree of cellularity in PA, and the location of the specimen. Conclusion: It seems that the expression of ERs does not play an effective role in the development and progression of PA. However, its occurrence in the normal salivary gland ducts is considerable, and further studies in this field seem to be necessary.

Immunohistochemical expression of ER and p53 as predictive biomarkers of immunotherapy in endometrial cancer.

e17626 Background: Immune Checkpoint Inhibitors (ICIs), either as monotherapy or in combination with tyrosine kinase inhibitors (TKIs), were recently incorporated into the therapeutic guidelines for recurrent/metastatic endometrial cancer (EC). Microsatellite Instability (MSI) is the only biomarker to guide treatment. We evaluated the predictive significance of Estrogen Receptor (ER) and p53 expression. Methods: Medical charts of EC patients that received ICIs in our institution for advanced/metastatic disease were retrospectively reviewed. TP53 and ER expression were determined by immunohistochemistry. Survival analysis was performed using IBM SPSS statistics v.25. Results: Thirty-two patients were included in our analysis. The median age was 63.1 years (25th-75th percentile: 57.6 – 69.6). 62.5% of the patients had endometrioid histology, 21.9% serous histology and 15.6% of them displayed other histology. 46.9% of the patients had grade 1-2 tumors and 53.1% grade 3 tumors. 21.9% of them were diagnosed with stage 1-2 disease, while 78.1% presented with stage 3 disease. 62.5% received 0-1 prior lines of treatment and 37.5% of them received more than 2 prior lines. Molecular characteristics are presented in the table. All MSI-High patients received anti-PD1 monotherapy with a median PFS of 11.9 months (95% CI:2.3-21.5). Microsatellite Stable (MSS) patients received pembrolizumab-lenvatinib combination with median PFS 7.54 months (95% CI:2.6-11.5). ER positivity was associated with significant PFS benefit in both the ICI monotherapy group (11.9 vs. 0.63 months, p=0.061) and the group that received ICI/TKI combination (11.3 vs. 1.75 months, p=0.001). Analogous benefit was noted in the Overall Survival post start of IO or IO/TKI treatment (9.8 vs 0.6 months in MSI-high patients and 20.6 vs 5.9 months in MSS patients). ER-positivity remained an independent predictive factor favoring PFS in the Multivariate Cox regression analysis when adjusting for immunotherapy type, histology, and previous lines of therapy (HR=0.216, p=0.013). Conclusions: ER expression proved to be an independent prognostic factor regarding PFS in our cohort of patients. Further studies are needed to investigate the role of ER as a predictive biomarker for immunotherapy in EC. [Table: see text]

Molecular Landscape of Mullerian Clear Cell Carcinomas Identifies The Cancer Genome Atlas-like Prognostic Subgroups

Mullerian clear cell carcinoma (CCC) is often aggressive and chemoresistant. The prognostic significance of molecular subclassification of endometrioid carcinomas is well established. However, less is known about the molecular landscape of CCC. The aim of this study was to better characterize the genetic landscape of a large cohort of CCC and correlate these findings with clinicopathologic features. CCC of the ovary (n = 72), endometrium (n = 24), and peritoneum/abdominal wall (n = 5) were retrospectively identified. Tumors had undergone tumor-only targeted sequencing using a hybrid capture next-generation sequencing panel. Median tumor mutational burden was 6.8 mutations/megabase (range, 1.3-185, 21% were ≥10 mutations/Mb). The most frequently mutated genes were ARID1A (48%), PIK3CA (45%), TP53 (23%), and PTEN (10%). ERBB2 amplification occurred in 4%. When classified according to the Cancer Genome Atlas/the Proactive Molecular Risk Classifier for Endometrial Cancer endometrial carcinoma molecular subgroups, 3 (3%) were POLE ultramutated, 5 (5%) were microsatellite instability-high (MSI-H), 20 (20%) were TP53-mutant subgroup, and 73 (72%) were no specific molecular profile (NSMP). Immunohistochemical expression of estrogen receptor, progesterone receptor, and programmed death-ligand 1 were not associated with the molecular subgroup. POLE and MSI-H tumors were characterized by an excellent prognosis, and the TP53-mutant subgroup had a worse disease-free survival than NSMP. NSMP tumors could be further substratified as high-risk NSMP if they lacked PIK3CA, PIK3R1, and ARID1A mutations, and/or harbored a TERT-promoter mutation. The Cancer Genome Atlas and NSMP-specific stratifications were prognostic for both the entire cohort and the subset of stage I ovarian tumors. On multivariable analysis, stage, lymphovascular invasion, and tumor mutational burden were prognostic for disease-free survival, whereas advanced stage and TP53-mutant subgroup – but not a TP53 mutation in isolation – were negative prognostic factors for overall survival. These data suggest that routine molecular profiling of Mullerian CCC may be warranted for both prognosis and identification of potential targeted treatments, such as immunotherapy and anti-HER2 agents.

The potential role of villin 1 and estrogen receptor (ER) in differentiation between endocervical adenocarcinoma and endometrial adenocarcinoma

Background: Endocervical adenocarcinoma (ECAC) is the 4th most common cancer in females globally. It has been ranked the 14th most common cancer in Egyptian females. The aim of this work was to study immunohistochemical expression of villin1 in endocervical and endometrial adenocarcinoma, immunohistochemical expression of ER in endocervical and endometrial adenocarcinoma and evaluate the potential role of villin 1 and ER expression in differentiation between endocervical & endometrial adenocarcinoma.Methods: This retrospective study was carried out on 60 cases of endocervical & endometrial endometroid adenocarcinoma. Patients were classified into two equal groups: Group I: Cases of endocervical adenocarcinomas and Group II: Cases of endometrial endometroid adenocarcinomas.Results: The positive predictive value of ER as a correlation between ER expression and clinicopathological characteristics has been addressed in our study was 100%. The negative predictive value was 73.1%. The positive predictive value of using panel of villin and ER expression and clinicopathological characteristics has been addressed in our study was 88.8%, the negative predictive value was 66.6%. Conclusions: Villin1 is good diagnostic tool had high specificity in differentiating endocervical and endometroid adenocarcinoma and has a predictive value in ECAC. ER is good diagnostic tool in differentiating between endocervical and endometroid adenocarcinomas and has predictive value in endometroid adenocarcinoma.

Correlation of B-cell lymphoma 2 immunoexpression in invasive carcinoma of breast, no special type with hormone receptor status, proliferation index, and molecular subtypes.

B-cell lymphoma 2 is involved in various cancers including breast carcinoma. Its expression in breast cancer has been associated with good prognostic factors such as hormone receptor expression, low Ki-67, low grade, and earlier stage. It is also considered to be an independent prognostic factor for luminal and triple-negative tumors. We aimed to determine the expression of B-cell lymphoma 2 (BCL2) in different molecular subtypes of invasive ductal carcinoma of breast and its association with prognostic indicators. Fifty samples of invasive carcinoma of breast, no special type (NST), were categorized into molecular subtypes according to immunohistochemical expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2 (HER2), and Ki-67 and then evaluated for BCL2 expression. The expression of BCL2 was correlated with ER, PR, HER2, and Ki-67 and compared between luminal and nonluminal subtypes. The BCL2 expression was seen in 68% of the cases with a significant association with ER, PR, and luminal subtypes. No significant association of BCL2 expression was seen with grade, HER2 and Ki-67 status of the tumor, or age group of the patients. BCL2 expression is significantly associated with ER, PR, and luminal subtypes in breast cancer. BCL2 is a marker of good prognosis in invasive carcinoma of breast, NST.

To Study Clinicopathological and Immunohistochemical Expression of Estrogen Receptor, Progesterone Receptor and Her-2/Neu in Prostate Carcinoma

Background: Prostate carcinoma is leading cause of cancer related deaths amongst men. This study evaluated expression of ER, PR, HER-2/neu in Prostatic carcinoma and its correlation with Gleason score and other clinical parameters.
 Methods: 50 histopathologically proven PCa cases were subjected to IHC for ER, PR, HER-2/neu.
 Result: Most common age group involved was 61-80years. Retention of urine was most frequent complaint. Most prominent Gleason score was (3+4) and group grade was 2. ER expression in tumor epithelial cells was 24% and in stromal cells was 36%. PR expression in stromal cells was 32%. HER-2/neu Cytoplasmic positivity was seen in 6% cases. It was seen that with increase in Gleason grade, ER, PR, HER-2/neu positivity was decreased.
 Conclusion: ER, PR, HER-2/neu can be used as biomarkers in PCa management.

Pathological and Immunohistochemical Microscopy of Natural Cases of Canine and Feline Neoplastic Mammary Lesions.

Mammary cancer is the second most common tumor worldwide. Small animal mammary neoplasms provide an outstanding model to study cancer in humans, as tumors in both share a similar environment, histopathologic features, and biological behavior. This study aims to investigate the percentage and microscopy of breast tumors in affected dogs and cats; its relationship to breed, age, and sex; and the immunohistochemical expression of estrogen receptor (ER), progesterone receptor (PR), Ki-67, and cytokeratin 8. Twenty-four females (12 dogs and 12 cats) and one male were examined from February 2018 to February 2020. The highest percentage of mammary neoplasia from the highest to the lowest manifested as tubular carcinoma, leiomyosarcoma, fibroadenoma, and cystic papillary carcinoma. The current study reported the second micropapillary invasive carcinoma in a male cat and the third lipid-rich carcinoma in a female cat. Although tubular carcinoma was the most common mammary neoplasm in cats, leiomyosarcoma was the most common in dogs. The immunohistochemical staining revealed diffuse and intense cytoplasmic immunoreactivity for cytokeratin 8 in lipid-rich carcinomas. However, moderate expression of ER in benign tumors and slight to moderate ER expression in malignant mammary lesions were reported. On the contrary, there was a negative PR expression in benign lesion. It could be concluded that a close relationship between ER expression and nuclear antigen Ki-67 was found.

The Value Of Immunohistochemical Expression Of Estrogen Receptor And Progesterone Receptor Receptors In The Prognosis Of Iraqi Women With Breast Carcinoma

Background: The basic microscopical structure of the adult female breast is composed primarily of two components. The first is an active adipocyte (mesenchyme). The second is an epithelial bilayer, which is supported by Cooper ligaments (a loose framework of dense fibrous connective tissue). Immunohistochemical evaluation of breast tissue is of diagnostic, prognostic, and therapeutic relevance. Estrogen receptor (ER) and progesterone receptor (PR) are playing a vital role in the management of breast cancer because they predict response to endocrine treatment; however, they have a little prognostic role regarding the fate of disease. These receptors had assessed by immunohistochemistry (IHC) that had performed on paraffin tissue preparations. Aim of the study: The current study was aiming at highlighting the value of immunohistochemical expression of ER and PR receptors in the prognosis of Iraqi women with breast carcinoma. Materials and methods: The current study was carried out at the central laboratory of Al-Diwaniyah teaching hospital and several private histopathology laboratories in Al-Diwaniyah province, the mid-Euphrates region of Iraq. The study was started in July 2019 and ended in February 2020. Thirty-paraffin sections of breast carcinoma had retrieved from these laboratories. One-section had been made from each paraffin block and stained by the conventional hematoxylin and eosin (H and E) stain. Then, the sections had reviewed by two pathologists, who confirmed the diagnosis, as well as the other related histological features like grade, histological subtype, stromal invasion, and lymphatic and neural permeation. Two-further sections had made for immunohistochemical staining with ER and PR receptor stains. Results: The immunohistochemical expression of ER and PR receptors was as following: Positive ER only cases were 3 (10.0 %), positive PR only cases were 4 (13.3 %), and the cases which were positive for both ER and PR were 15 (50.0 %). The Cases that were negative for both ER and PR accounted for 8 (26.7 %). Total cases expressing ER accounted for 18 (60.0 %), and the cases that express PR had accounted for 19 (63.3 %). Conclusion: The immunohistochemical expression of ER and PR receptors is heterogeneous concerning the proportion and intensity of staining, and this may explain the variation of breast cancer cases in response to hormonal therapy.

The relationship of tumor microenvironment and clinico-pathological parameters in different molecular subtypes of breast cancer

Introduction: Tumor microenvironment plays a significant role in tumor progression. Tumor stroma is one of the strongest modifiers of tumor cell response, cancer behavior, and cancer progression. This study aimed to investigate the correlation of matrix metalloproteinase-9 (MMP-9) expression and tumor-stroma ratio (TSR) with standard clinicopathological parameters in different molecular subtypes of breast cancer.Methods: Ninety biopsy samples of primary breast cancer diagnosed at the Department of Pathology, School of Medicine, Sarajevo, were selected for this study. The molecular subtype was determined based on the immunohistochemical expression of estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and Ki-67. Stromal and tumoral MMP-9 immunohistochemical expression and the TSR were determined for each tumor.Results: Tumoral MMP-9 expression correlated positively with the presence of lymphovascular invasion (p= 0.016). TSR showed significant association and correlation with tumor grade (G) (p= 0.031; p= 0.049) and tumor size (pT) (p = 0.049;p= 0.021, respectively). Stromal MMP-9 expression correlated with histologic type, histologic grade of tumor, and lymphocytic inflammatory infiltrate (p= 0.021;p= 0.047, p= 0.038, respectively). A higher percentage of stromal MMP-9 expression correlated with the strongest lymphocytic response (p = 0.007). Significant correlation was observed between molecular subtypes and histologic grade of the tumor (p= 0.032).Conclusion: Our results, to some extent, confirm the significance of the tumor microenvironment in breast cancer, especially when it is about stromal MMP-9 expression. Although we observed significant association, without linear correlation, we found no significant correlation between molecular subtypes of breast cancer and MMP-9 expression.

The cutoff for estrogen and progesterone receptor expression in endometrial cancer revisited: a European Network for Individualized Treatment of Endometrial Cancer collaboration study

There is no consensus on the cutoff for positivity of estrogen receptor (ER) and progesterone receptor (PR) in endometrial cancer (EC). Therefore, we determined the cutoff value for ER and PR expression with the strongest prognostic impact on the outcome. Immunohistochemical expression of ER and PR was scored as a percentage of positive EC cell nuclei. Cutoff values were related to disease-specific survival (DSS) and disease-free survival (DFS) using sensitivity, specificity, and multivariable regression analysis. The results were validated in an independent cohort. The study cohort (n=527) included 82% of grade 1-2 and 18% of grade 3EC. Specificity for DSS and DFS was highest for the cutoff values of 1-30%. Sensitivity was highest for the cutoff values of 80-90%. ER and PR expression were independent markers for DSS at cutoff values of 10% and 80%. Consequently, three subgroups with distinct clinical outcomes were identified: 0-10% of ER/PR expression with, unfavorable outcome (5-year DSS = 75.9-83.3%); 20-80% of ER/PR expression with, intermediate outcome (5-year DSS = 93.0-93.9%); and 90-100% of ER/PR expression with, favorable outcome (5-year DSS = 97.8-100%). The association between ER/PR subgroups and outcomes was confirmed in the validation cohort (n=265). We propose classification of ER and PR expression based on a high-risk (0-10%), intermediate-risk (20-80%), and low-risk (90-100%) group.

The hispanic landscape of triple negative breast cancer.

Triple-negative breast cancer (TNBC) is a heterogeneous and complex disease characterized by the absence of immunohistochemical expression of estrogen receptor, progesterone receptor and HER2. These breast tumors present an aggressive biology and offer few opportunities to be treated with targeted therapy resulting in bad disease outcomes. The epidemiology of TNBC is intriguing where the understanding of its biology has progressed quickly. One of the peculiarities of this type of cancer is a high prevalence in Afrodescendants and Hispanic patients compared to Caucasian women. In this review we describe some features of TNBC, focusing in the Hispanic population, such as epidemiological, clinicopathological features and molecular features and the correlation between TNBC prevalence and the human development index.

Immunohistochemical expression of estrogen receptor α, Bcl-2 and NF-κB P65 in the polyps of patients with and without endometriosis.

To compare the expression of estrogen receptor α (ERα), Bcl-2 and NF-κB P65 in endometrial polyps from patients with and without endometriosis. Immunohistochemistry was used to characterize the expression of ERα, Bcl-2 and NF-κB P65 in proliferative phase endometrial polyps from patients with and without endometriosis. H-Scores indicating the staining intensity for ERα, Bcl-2 and NF-κB P65 in the glandular epithelium and stroma were measured separately. Apoptotic cells were detected with the use of the dUTP nick-end labeling (TUNEL) assay. Bcl-2 was expressed in the cytoplasm of glandular epithelial cells, whereas ERα was expressed in the nuclei of both glandular epithelial and stromal cells. NF-κB P65 was observed in the cytoplasm of both glandular epithelial and stromal cells. The H-scores for Bcl-2 in the endometrial glands significantly higher in the endometriosis polyp group than in the non-endometriosis polyp group. The H-scores for ERα in both stromal and glandular epithelial cells were significantly higher in the endometriosis polyp group than in the non-endometriosis polyp group. The H-scores for Bcl-2 and ERα were positively correlated in all of the women examined. Apoptotic cells in the endometriosis polyp group were significantly less than that of the non-endometriosis polyp group. There expression levels of Bcl-2 and ERα, both of which were significantly increased in the polyps of endometriosis patients compared to those of patients without endometriosis, were positively correlated. These results suggested that imbalanced apoptosis secondary to abnormally high ERα expression was responsible for the high prevalence of polyps in endometriosis patients.

Preoperative risk stratification in endometrial cancer (ENDORISK) by a Bayesian network model: A development and validation study.

BackgroundBayesian networks (BNs) are machine-learning–based computational models that visualize causal relationships and provide insight into the processes underlying disease progression, closely resembling clinical decision-making. Preoperative identification of patients at risk for lymph node metastasis (LNM) is challenging in endometrial cancer, and although several biomarkers are related to LNM, none of them are incorporated in clinical practice. The aim of this study was to develop and externally validate a preoperative BN to predict LNM and outcome in endometrial cancer patients.Methods and findingsWithin the European Network for Individualized Treatment of Endometrial Cancer (ENITEC), we performed a retrospective multicenter cohort study including 763 patients, median age 65 years (interquartile range [IQR] 58–71), surgically treated for endometrial cancer between February 1995 and August 2013 at one of the 10 participating European hospitals. A BN was developed using score-based machine learning in addition to expert knowledge. Our main outcome measures were LNM and 5-year disease-specific survival (DSS). Preoperative clinical, histopathological, and molecular biomarkers were included in the network. External validation was performed using 2 prospective study cohorts: the Molecular Markers in Treatment in Endometrial Cancer (MoMaTEC) study cohort, including 446 Norwegian patients, median age 64 years (IQR 59–74), treated between May 2001 and 2010; and the PIpelle Prospective ENDOmetrial carcinoma (PIPENDO) study cohort, including 384 Dutch patients, median age 66 years (IQR 60–73), treated between September 2011 and December 2013. A BN called ENDORISK (preoperative risk stratification in endometrial cancer) was developed including the following predictors: preoperative tumor grade; immunohistochemical expression of estrogen receptor (ER), progesterone receptor (PR), p53, and L1 cell adhesion molecule (L1CAM); cancer antigen 125 serum level; thrombocyte count; imaging results on lymphadenopathy; and cervical cytology. In the MoMaTEC cohort, the area under the curve (AUC) was 0.82 (95% confidence interval [CI] 0.76–0.88) for LNM and 0.82 (95% CI 0.77–0.87) for 5-year DSS. In the PIPENDO cohort, the AUC for 5-year DSS was 0.84 (95% CI 0.78–0.90). The network was well-calibrated. In the MoMaTEC cohort, 249 patients (55.8%) were classified with <5% risk of LNM, with a false-negative rate of 1.6%. A limitation of the study is the use of imputation to correct for missing predictor variables in the development cohort and the retrospective study design.ConclusionsIn this study, we illustrated how BNs can be used for individualizing clinical decision-making in oncology by incorporating easily accessible and multimodal biomarkers. The network shows the complex interactions underlying the carcinogenetic process of endometrial cancer by its graphical representation. A prospective feasibility study will be needed prior to implementation in the clinic.

Comparative Evaluation of Immunohistochemical Expression of Estrogen Receptor, Progesterone Receptor and HER2 in Fine Needle Aspiration Cell Blocks and Surgical Biopsies in Primary Breast Carcinoma

Comparative Evaluation of Immunohistochemical Expression of Estrogen Receptor, Progesterone Receptor and HER2 in Fine Needle Aspiration Cell Blocks and Surgical Biopsies in Primary Breast Carcinoma

Clinicopathological and immunohistochemical study of male breast carcinoma: Experience from a tertiary care teaching hospital of South India

Introduction: Male breast carcinoma (MBC) accounts for 1% of all breast carcinomas. Compare to female counter part, they present with advance stage and high lymph node positivity and carries a poor prognosis. Invasive ductal carcinoma (IDC) no special type was the most common histopathological type. They express high hormonal receptor positivity. Few epidemiological studies of MBC are available in the northern part of India, but studies in the Southern India are spares. Hence, this study was undertaken to document the clinicopathological parameters and IHC profile associated with MBC in this region of India.Materials and Methods: This is a retrospective study for a period of 10 years. Each case was assessed for clinical presentation, laterality, quadrant of the breast involved, fine-needle aspiration cytology diagnosis, mammography, type of surgery, size of tumor, histopathological diagnosis, lymph node status, metastasis, SBR grading, and TNM staging. Immunohistochemical expression of estrogen receptor, progesterone receptor, human epidermal growth factor receptor-2 (Her 2) Neu, and Ki 67 was graded as per the standard protocol.Results: During the study period, 16 MBC were observed, constituting 1.5%. The median age is 59 years; painless lump is the most common presentation. IDC no special type is the most common variant. The left breast was commonly affected (81.25%). None of them had a family history of breast carcinoma; central subareola region is the most common anatomical site involved. 62.5% were in Grade 2 and 28.5% showed ipsilateral axillary lymph node involvement. High hormonal receptor positivity was noted in 100% cases, whereas 12.5% showed Her 2 amplifications.Conclusion: Our study also conclude that the pathology of MBC is as most of the cases are presenting with Stage 2 and less lymph node involvement which may carry a better prognosis; however, more studies on the large sample are required to document the same.

Correlations between exposure to deoxynivalenol and zearalenone and the immunohistochemical expression of estrogen receptors in the intestinal epithelium and the mRNA expression of selected colonic enzymes in pre-pubertal gilts

Plant-based materials used in the production of pig feed are very often contaminated with deoxynivalenol and zearalenone. Daily intake of small amounts of these mycotoxins with feed induces various subclinical states in gilts and influences different biological processes. The aim of this preclinical study was to determine the correlation between monotonic doses of zearalenone and deoxynivalenol (40 μg/kg body weight and 12 μg/kg body weight, respectively, administered over a period of 42 days) and the immunohistochemical expression of estrogen receptors in the intestinal tract and the mRNA expression of selected colonic enzymes. The immunohistochemical expression of estrogen receptor alpha was observed in the colon, but its intensity varied in different weeks of exposure. A minor increase in estrogen receptor beta expression was noted only in the colon, whereas the expression of cytochrome P450 1A1 enzyme mRNA and mRNA isoform of the glutathione S-transferase π gene decreased. The observed correlations suggest that the risk of loss of control over the biotransformation and biological activity of the parent compounds in distal intestinal mucosa is delayed.

Immunohistochemical Expression of ER, PR and HER2/neu in Endometrial Carcinoma

Endometrial carcinoma (EC) is the third common gynecologic cancer in India. It consists of two major histological types: the most common endometrioid or type I EC and non-endometrioid or type II EC. They are biologically distinct, and various markers have been proposed as prognostic biomarkers in EC besides clinical and pathological features. To study the immunohistochemical (IHC) expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER2/neu) in EC and to correlate them with various clinicopathological parameters. IHC study of ER, PR and HER2/neu was performed on 35 cases of histopathologically diagnosed EC in hysterectomy specimens for a period of 4 years from 2014 to 2017. Majority of the patients were aged 51–60 years, and the common comorbid conditions were type 2 diabetes mellitus, hypertension and obesity. Histologically, 31 (88.57%) cases were of type 1 EC and 4 (11.43%) were of type II EC; in type II EC, 2 (5.7%) cases were papillary serous carcinoma and the remaining two cases each were malignant mixed Mullerian tumor (MMMT) and dedifferentiated carcinoma (DC). ER expression was observed in 29 cases (82.9%) and was statistically significant with tumor stage, tumor grade, histological type and intraglandular necrosis. PR expression was seen in 22 (62.9%) cases and showed significant association with tumor grade, myometrial invasion and histological type. HER2/neu was expressed in one case. Establishing the diagnosis of molecular subtype of EC with limited markers, namely ER/PR, HER2/neu expression similar to breast cancer, may be useful to determine the treatment and prognosis, especially in developing countries. Studies with larger sample sizes may elucidate their role, which was the limitation in this study.

Expression of Estrogen Receptors (ER), Progesterone Receptors (PR) and HER-2/neu receptors in Endometrial Carcinoma and their associations with histological types, grades and stages of the tumor.

Objective:To study and detect immunohistochemical expression of Estrogen Receptors, Progestrone Receptors and HER-2/neu Receptors in Endometrial Carcinoma (EC) and to find their associations with histological types, grades and stages of the tumor.Methods:A cross sectional study of one year duration from January 2016 to January 2017 was conducted at Histopathology department of Army Medical College, Rawalpindi. A non-probability purposive sampling technique was used to include 56 cases of EC. The specimens were tested for ER, PR and HER-2/neu expression using immunohistochemical analysis. Data was analyzed in SPSS and the significance of association of expression of the receptors with histological types, grades and stages of the tumor was assessed.Results:Significant association of Her-2/neu overexpression with histological types and grades of EC was seen, whereas the association of ER and PR expression with histological types, grades and stage of EC was statistically insignificant.Conclusion:It is suggested that EC showing over expression of HER2/neu with immunohistochemistry may be treated with anti HER-2/neu treatment with better chances of survival and decreased post-treatment morbidity.

Intratumoral Heterogeneity in Breast Cancer: A Comparison of Primary and Metastatic Breast Cancers.

Intratumoral heterogeneity presents challenges in the management of cancer. To gain deeper insight in intratumoral heterogeneity at different levels and tumor sites for common biomarkers in breast cancers, this report examines seven cases of invasive breast cancer with multiple axillary nodal metastases and/or recurrences for immunohistochemical expression of estrogen receptors, progesterone receptors, human epidermal growth receptor 2, and Ki67 on all tissue blocks in both primary and metastatic tumors. The Oncologist 2017;22:487-490.